Departments
Health Matters
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Week of 17 September 1999 |
Vol. III, No. 6 |
Health Matters
Fancy footwork: outmaneuvering warts and ingrown toenails
I have recurring ingrown toenails and plantar warts on my feet. Is there something wrong with my feet? What can I do to prevent them from coming back?
Ingrown toenails and plantar warts are among the most common foot problems in America and are among health problems most often treated at home. Usually affecting the big toe, an ingrown toenail occurs when the edge of the nail is driven into soft tissue surrounding the nail. This is generally caused by the pressure of tight shoes, orthopedic deformities of the foot, abnormal shape or alignment of the nail plate, or improper cropping of the nail, says Lynne Goldberg, M.D., an assistant professor of dermatology and pathology at Boston University School of Medicine. While most common in young adults, anyone can have ingrown toenails. In the elderly, they commonly happen because of acquired abnormalities of the nail plate.
Symptoms include localized pain, red skin surrounding the nail, and an accumulation of pus, which may indicate an infection. According to Goldberg, most ingrown toenails can be treated at home by soaking the toe in warm or hot water several times a day. Individuals with ingrown toenails can also elevate the affected nail by placing a cotton ball underneath it daily until the corner of the nail has grown past the point where it cuts into the skin.
"Infected ingrown toenails generally respond well to local measures, so medication is not often required," says Goldberg. "Oral antibiotics are prescribed if there is an accompanying severe infection. Most ingrown toenails go away within one to three weeks, although reoccurrence can be a problem." Prevention is simple -- most ingrown toenails, except those caused by a hereditary problem, can be avoided by trimming the toenail flat across rather than in a curve and by wearing properly fitting shoes.
Plantar warts
Plantar warts are caused by the human papilloma virus, the
virus that also causes warts on other parts the body.
Generally, plantar warts are found on the heel of the foot,
but they can occur elsewhere on the foot as well. About 1 to
2 percent of the general population has suffered from the
irritation, with the number rising to about 25 percent in
areas where young adults and adolescents live together and
bathe in common areas, including boarding schools, public
baths, and military dwellings.
Symptoms of plantar warts include tenderness and localized pain, especially when the warts are on weight-bearing areas of the foot. The skin may be yellow, or raised and contain black dots.
Since they are cause by a virus, plantar warts can be highly contagious. Whether a person becomes infected depends more on the strength of the immune system than on the amount of exposure to the virus. Recipients of organ transplants and cancer patients who take drugs to suppress the immune system have an increased susceptibility to plantar warts.
Treatments for plantar warts include destroying the infected skin with an over-the-counter medication containing salicylic acid and then filing away the dead skin, or using liquid nitrogen to freeze the affected area and then scraping the dead skin away. According to Goldberg, the latter treatment typically involves several visits to the doctor's office before the wart is totally removed. Surgery is very rarely performed to remove plantar warts because painful scar tissue is left on the sole of the foot.
"Some plantar warts eventually heal themselves," says Goldberg. She adds that plantar warts can sometimes be confused with corns and calluses, which are both normal skin responses to localized pressure. Corn pads with salicylic acid may help plantar wart sufferers, especially for lessening pain, she says, but "those without [salicylic acid] don't do much."
To prevent plantar warts, individuals with compromised immune systems should avoid public swimming pools and bathing areas, and if possible, use a different bathing area than family members who have warts.
"Health Matters" is written in cooperation with staff members of Boston Medical Center and Boston University School of Medicine. For more information about ingrown toenails and plantar warts or other health matters, call 638-6767.